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Blunt laryngeal trauma secondary to sporting injuries

Published online by Cambridge University Press:  09 June 2017

D Mendis  and
J A Anderson
D Mendis
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Canada
J A Anderson*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Canada
*
Address for correspondence: Dr Jennifer Anderson, Department of Otolaryngology – Head and Neck Surgery, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada Fax: +1 416 864 5367 E-mail: [email protected]
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Abstract

Background:

Laryngeal injury after blunt trauma is uncommon, but can cause catastrophic airway obstruction and significant morbidity in voice and airway function. This paper aims to discuss a case series of sports-related blunt laryngeal trauma patients and describe the results of a thorough literature review.

Method:

Retrospective case-based analysis of laryngeal trauma referrals over six years to a tertiary laryngology centre.

Results:

Twenty-eight patients were identified; 13 (46 per cent) sustained sports-related trauma. Most were young males, presenting with dysphonia, some with airway compromise (62 per cent). Nine patients were diagnosed with a laryngeal fracture. Four patients were managed conservatively and nine underwent surgery. Post-treatment, the majority of patients achieved good voice outcomes (83 per cent) and all had normal airway function.

Conclusion:

Sports-related neck trauma can cause significant injury to the laryngeal framework and endolaryngeal soft tissues, and most cases require surgical intervention. Clinical presentation may be subtle; a systematic approach along with a high index of suspicion is essential, as early diagnosis and treatment have been reported to improve airway and voice outcome.

Keywords

Sporting InjuriesLarynxTraumaNeck InjuriesIce Hockey
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 8 , August 2017 , pp. 728 - 735
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Gussack, GS, Jurkovich, GJ, Luterman, A. Laryngotracheal trauma: a protocol approach to a rare injury. Laryngoscope 1986;96:660–5Google Scholar
2 Delaney, JS, Al-Kashmiri, A. Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football. Br J Sports Med 2005;39:e2 Google Scholar
3 Lawrence, LA, Svider, PF, Raza, SN, Zuliani, G, Carron, MA, Folbe, AJ. Hockey-related facial injuries: a population-based analysis. Laryngoscope 2014;125:589–93Google Scholar
4 Paluska, SA, Lansford, CD. Laryngeal trauma in sport. Curr Sports Med Rep 2008;7:16–21 Google Scholar
5 ATLS Subcommittee; American College of Surgeons’ Committee on Trauma; International ATLS Working Group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg 2013;74:1363–6Google Scholar
6 Rosen, CA, Lee, AS, Osborne, J, Zullo, T, Murry, T. Development and validation of the voice handicap index-10. Laryngoscope 2004;114:1549–56Google Scholar
7 Butler, AP, Wood, BP, O'Rourke, AK, Porubsky, ES. Acute external laryngeal trauma: experience with 112 patients. Ann Otol Rhinol Laryngol 2005;114:361–8Google Scholar
8 Poburka, B. A new stroboscopy rating form. J Voice 1999;13:403–13CrossRefGoogle ScholarPubMed
9 Schaefer, SD, Close, LG. Acute management of laryngeal trauma. Update. Ann Otol Rhinol Laryngol 1989;98:98–104 Google Scholar
10 Omakobia, E, Micallef, A. Approach to the patient with external laryngeal trauma: the Schaefer classification. Otolaryngol (Sunnyvale) 2016;6:230 Google Scholar
11 Juutilainen, M, Vintturi, J, Robinson, S, Bäck, L, Lehtonen, H, Mäkitie, AA. Laryngeal fractures: clinical findings and considerations on suboptimal outcome. Acta Otolaryngol 2008;128:213–18Google Scholar
12 Kim, JP, Cho, SJ, Son, HY, Park, JJ, Woo, SH. Analysis of clinical feature and management of laryngeal fracture: recent 22 case review. Yonsei Med Journal 2012;53:992–8Google Scholar
13 Sidle, DM, Altman, KW. The contralateral injury in blunt laryngeal trauma. Laryngoscope 2002;112:1696–8Google Scholar
14 Gussack, GS, Jurkovich, GJ. Treatment dilemmas in laryngotracheal trauma. J Trauma 1988;28:1439–44CrossRefGoogle ScholarPubMed
15 Cheong, KF, Yau, GH. Acute laryngeal trauma. J Anesth 1995;9:360–2Google Scholar
16 Atkins, BZ, Abbate, S, Fisher, S, Vaslef, SN. Current management of laryngotracheal trauma: case report and literature review. J Trauma 2004;56:185–90Google Scholar
17 Waldron, RJ, Young, RJ. Traumatic tracheal transection. Anaesth Intensive Care 1993;21:105–19Google Scholar
18 Cicala, RS, Kudsk, KA, Butts, A, Nguyen, H, Fabian, TC. Initial evaluation and management of upper airway injuries in trauma patients. J Clin Anesth 1991;3:91–8CrossRefGoogle ScholarPubMed
19 Gold, SM, Gerber, ME, Shott, SR, Myer, CM. Blunt laryngotracheal trauma in children. Arch Otolaryngol Head Neck Surg 1997;123:83–7Google Scholar
20 Schaefer, SD. Management of acute blunt and penetrating external laryngeal trauma. Laryngoscope 2013;124:233–44Google Scholar
21 Minard, G, Kudsk, KA, Croce, MA, Butts, J, Cicala, RS, Fabian, TC. Laryngotracheal trauma. Am Surg 1992;58:181–7Google Scholar
22 Schaefer, SD. The acute management of external laryngeal trauma. A 27-year experience. Arch Otolaryngol Head Neck Surg 1992;118:598–604 CrossRefGoogle ScholarPubMed
23 Sandhu, G, Nouraei, SA. Laryngeal trauma. In: Kirtane, MV, de Souza, CE, eds. Laryngology, Otorhinolaryngology Head and Neck Surgery Series. Delhi: Thieme, 2014;236Google Scholar
24 Beckera, A, Leuchterb, I, Platona, A, Beckera, CD, Dulguerovb, P, Varoquauxa, A. Imaging of laryngeal trauma. Eur J Radiol 2014;83:142–54Google Scholar